Objective To investigate the effects of small tidal volume combined with PEEP on extravascular lung water during one-lung ventilation (OLV) in patients undergoing thoracic surgery. Methods Forty ASA Ⅰ or Ⅱ patients of both sexes aged 45-80 yr undergoing esophagectomy for esophageal cancer were randomly assigned into 2 groups (n = 20 each):group Ⅰ IPPV (VT 9 ml/kg ,RR 12 bpm) and group Ⅱ IPPV +PEEP (VT 6 ml/kg, RR 15 bpm, PEEP 5 cm H-2O). FiO2 was 100% and I:E 1:2 in both groups. Anesthesia was induced with fentanyl 3-5 μg/kg, propofol 1.0-1.5 mg/kg and vecuronium 0.10-0.15 mg/kg and maintained with continuous infusion of propofol 4-7 mg· kg- 1 · h - 1 and vecuronium 0.07-0.08 mg- kg- 1 · h - 1 and intermittent iv boluses of fentanyl. Double lumen endobronchial tube was inserted. Correct position was confirmed by bronchoscopy. Right internal jugular vein was cannulated. A 4F thermodilution catheter was inserted into right femoral artery and connected to PICCO monitor. Extravascular lung water (EVLW), EVLW index (EVLWI),pulmonary vascular permeability index (PVPI), cardiac output (CO) and oxygenation index (OI) were recorded before anesthesia (T0, baseline), at 30 min of two lung ventilation (T1), 30 min and 1 h of OLV (T2, T3),before extubation (T4) and 18 h after operation (T5). Airway peak pressure (Ppeak) was recorded at T1-4. Results EVLWI and PVPI were significantly higher in group IPPV + PEEP than in group IPPV. There was no significant difference in Ppeak, CO and OI at any time point between the 2 groups. In group IPPV there was no significant change in EVLW and EVLWI during and after mechanical ventilation, while PVPI was significantly increased at T1 as compared with the baseline before anesthesia. In group IPPV + PEEP EVLW was significantly increased at T2 and PVPI was significantly increased at T1 and T2 compared with the baseline at T0. Conclusion OLV with IPPV + PEEP results in more EVLW and it exerts no significant effect on lung function.

2.83 cm(left-right).The density of lymphocele was homogeneous ,with 0~15 HU(mean value,5.7HU).Adjacent organs were displaced by compression of lymphocele.Conclusion It should be diagnosed as a lymphocele if a pelvic cyst is found in postoperation of pelvic malignant tumor.

Objective To perform thermoluminescent measurements of radial dose function and anisotropy function of a newly designed 192Ir microSelectron-HDR source, and establish evaluation methods for HDR dosimetry.Methods A polystyrene phantom with sylindrical holes in different measure positions was designed to accommodate thermo luminescent dosimeter (TLD) rods and radiation source.TLD rods with similar sensitivity were placed on a semicircle around the source center which had been precisely localized by either radiographic means or dose measurement.Dose-rates were measured at θ = 90° and r = 1-14 cm to calculate radial dose function (gL (r)), while measured along polar angles θ = 0° -165°(interval 15°) at radial distances r = 1 cm, 3 cm and 5 cm to calculate anisotropy function (F(r,θ)).All data were compared with those calculated by Monte Carlo (MC) method.The t-test was used for the statistics.Results The values of gL (r) were 1.007 -0.681 by calculation and 1.007 -0.598 by measurement with r = 1 - 14 cm(t = 0.00 - 2.89, all P > 0.05).The values of F (r,θ) were 0.631 - 1,0.660 - 1 and 0.696 - 1 by calculation, while 0.701 - 1, 0.668 - 1 and 0.629 - 1 by measurement at 1 cm, 3 cm and 5 cm with θ=0° -165°(t=0.40 -1.63, 0.02 -2.10, 0.08 -2.03, all P>0.05).Conclusions The results of radial dose function and anisotropy function measured by TLD measurement are in consistent with those calculated by MC calculations, which can be applied in treatment planning system as original input.

Objective To study the imaging findings of the normal acromioclavicular joint and acromioclavicular dislocation.Methods CR films of normal shoulder in 68 cases and normal chest in 400 cases were collected.The distances of the acromioclavicular joint were measured,and the inferior cortex line of the acromioclavicular joint was observed on CR.MRI in 30 cases with normal shoulder,24 cases with acromioclavicular dislocation and 7 cases with shoulder impingement syndrome were also presented.Results The normal distance of the acromioclavicular joint was (3.36±0.44) mm.There was an arch line on the inferior cortex of the acromioclavicular joint for normal subjects.According to the Rockwood classification,acromioclavicular dislocation included type Ⅰ in 7/24 cases,type Ⅱ in 5/24 cases and type Ⅲ in 12 cases.The distances of the acromioclavicular joint were increased(＞4.3 mm) in type Ⅱ and type Ⅲ,and the inferior cortex lines of the acromioclavicular joint were not continual in type Ⅲ.MR imaging showed that the intra-articular fibrocartilaginous disk,the capsular and acromioclavicular ligament structure were ruptured in type Ⅱ,and coracoclavicular ligament torn in type Ⅲ.Conclusion The distance and the inferior cortex line of the acromioclavicular joint are of important value in diagnosis and classification of acromioclavicular dislocation.MRI is the most significant method in diagnosis of acromioclavicular dislocation.

Objective To study the findings of 256‐slice CT angiography in atherosclerosis of the intracranial carotid arteary . Methods 402 cases of atherosclerotic lesions in the neck and brain were collected from 2013 to 2014 in our hospital ,in which there were 274 cases of male and 128 cases female .All patients underwent 256‐slice CT angiography of the head and neck .The incidence of atherosclerosis involvement in the intracranial carotid artery was analysed .The characteristics of carotid plaque on different sexes , age(≤60 years and >60 years) and location (right and left ) were observed .The length and property of plaque ,and stenostic rate of the artery were measured respectively .Results There were 164 cases (40 .80% ) of intracranial carotid artery athrosclerosis in 402 cases of atherosclerotic lesions of the neck and brain ,in which the incident rate of male was 38 .32% and female 46 .09% (χ2 =2 .182 ,P=0 .140) .The incident rate of >60 years group was more than that of ≤60 years group (χ2 <31 .105 ,P<0 .001)for both sexes . There were no differences on lesion location (right or left)for different sexes or age groups (χ2 <0 .035 ,P>0 .088) .And there were also no differences on lesion length (≤10 mm ,11-20 mm ,>20 mm) for different sexes or age groups (χ2 <0 .027 ,P>0 .091) . Calcified plaques were seen the most (79 .81% ) ,mixed plaques were seen more (15 .46% ) ,and lipid plaques (1 .58% ) and fibrous plaques (3 .15% ) were seen less .The mixed plaques were more seen on >60 years group than that on ≤60 years group for male pa‐tients (χ2 =12 .204 ,P=0 .001) ,but no other difference was found for plaque property in other different sexes or age groups .Mild stenosis of the corated artery was found in 54 .57% lesions ,moderate stenosis in 39 .75% and severe stenosis in 5 .68% ,and there were no any difference in different sexes or age groups (χ2 <2 .062 ,P>0 .151) .Conclusion CT angiography of the head and neck is of important significance for diagnosis of atherosclerosis in the intracranial carotid artery .

Objective To study the incidence and clinical significance of the herniation pits of the femoral neck.Methods 600 cases(299 men,301 women,18～82 years)were collected.The incidence,radiologic finding and clinical significance of the herniation pit of the femoral neck were analysed.Results Of 1200 hip joints in 600 cases,there was 58 cases(64 sides)(5.3%)with herniation pits of the femoral neck,including 39 men(68.7%)and 19 women(31.3%),the lesions localized in the left joint in 25 eases(39.1%),in the right joint in 27 cases(42.2%)and in bilateral joints in 6 cases(18.7%).There were a obvious significant differences on both sexes,and no significant differences on age groups.On X-ray film,the lesions appeared as a round radiolucency with thin clear sclerotic rim.Conclusion The incidence of the herniation pit of the femoral neck is 5.3%,which has a typical X-ray feature,and may indicate the femoroacetabular impingement.

Objective To study the development characteristics of cavum sepit pellucidun (CSP)in prematures,neonates,infants and adults with MRI.Methods Brain MR images of different subjects including 141 prematures,106 neonates,171 infants and 35 046 adults were observed to determine the incidence and shape of CSP,and to measure its transverse diameter.Results CSP incidences were 100% (141/141)in prematures,97.17% (103/106)in neonates,2.26%(4/177)in infants and 0.82% (287/35 046)in adults respectively,and the CSP was cylinder (44.00%)or triangle in shape (56.00%)in prematures,triangle (76.40%)or fissure in shape (23.60%)in neonates.For infants or adults,each shape accounted for about a third of three kinds of shape respectively.Its mean transverse diameters were 5.7 mm in prematures,4.1 mm in neonates,13.3 mm in infants and 14.3 mm in adults respectivity.Conclusion CSP has different performances at development periods in human being brain.Most close after birth,while fewer remain in the whole life.

Objective To study the imaging finding of the coracoclavicular ligament.Methods 400 cases of normal chest films 200 men and 200 women were collected.The presented rates of pseudoarthrosis of the coracoclavicular joints and the clavicular tuberosities which are the coracoclavicular ligament attachment were evaluated and the distances between the clavicle and coracoid process interval were measured.There were 30 cases of normal shoulder MRI,the displaying rate of coracoclavicular ligament, the length and width of the coracoclavicular ligament were measured at MR imaging.8 case with type Ⅱ(n=5) and type Ⅲ(n=3)of acromioclavicular injury were also included in this study.Results Among 400 cases(800 sides),one pseudoarthrosis(0.25%)and 198 clavicular tuberosities(24.8%)were found.The normal distance between the clavicle and coracoid process interval was (6.92±3.16)mm.On MRI study,30 cases of coracoclavicular ligament were all showed on oblique coronal slices. The acromioclavicular ligament and coracoclavicular ligament tear were found in type Ⅱ and type Ⅲ,of acromioclavicular injury respectively on MRI.The length and width of conoid ligament were(11.48±1.43) mm and (4.82±1.21) mm respectively,and the length and width of trapezoid ligament were(9.09±0.84) mm and (5.10±0.87) mm respectively.Conclusion The normal anatomic measurement standards of the coracoclavicular ligament are established on X-ray and MRI,which is important for diagnosis of coracoclavicular ligament lesions.The coracoclavicular ligament torn is showed in typeⅢ of acromioclavicular dislocation.